Past research provides strong evidence that adverse life events heighten the risk of delinquent behavior among adolescents. Urban informal (slum) settlements in sub-Saharan Africa are marked by extreme adversity. However, the prevalence and consequences of adverse life events as well as protective factors that can mitigate the effects of exposure to these events in slum settlements is largely understudied.
Kabiru et al Child and Adolescent Psychiatry and Mental Health 2014, 8:24 http://www.capmh.com/content/8/1/24 RESEARCH Open Access Adverse life events and delinquent behavior among Kenyan adolescents: a cross-sectional study on the protective role of parental monitoring, religiosity, and self-esteem Caroline W Kabiru1*, Patricia Elung’ata1, Sanyu A Mojola2 and Donatien Beguy1 Abstract Background: Past research provides strong evidence that adverse life events heighten the risk of delinquent behavior among adolescents Urban informal (slum) settlements in sub-Saharan Africa are marked by extreme adversity However, the prevalence and consequences of adverse life events as well as protective factors that can mitigate the effects of exposure to these events in slum settlements is largely understudied We examine two research questions First, are adverse life events experienced at the individual and household level associated with a higher likelihood of delinquent behavior among adolescents living in two slums in Nairobi, Kenya? Second, are parental monitoring, religiosity, and self-esteem protective against delinquency in a context of high adversity? Methods: We used cross-sectional data from 3,064 males and females aged 12–19 years who participated in the Transitions to Adulthood Study We examined the extent to which a composite index of adverse life events was associated with delinquent behavior (measured using a composite index derived from nine items) We also examined the direct and moderating effects of three protective factors: parental monitoring, religiosity, and self-esteem Results: Fifty-four percent of adolescents reported at least one adverse life event, while 18% reported three or more adverse events For both males and females, adversity was positively and significantly associated with delinquency in bivariate and multivariate models Negative associations were observed between the protective factors and delinquency Significant adverse events × protective factor interaction terms were observed for parental monitoring (females and males), religiosity (males), and self-esteem (females) Conclusions: Similar to research in high income countries, adverse life events are associated with an increased likelihood of delinquent behavior among adolescents living in urban slums in Kenya, a low-income country However, parental monitoring, religiosity, and self-esteem may moderate the effect of adversity on delinquent behavior and pinpoint possible avenues to develop interventions to reduce delinquency in resource-poor settings in low and middle income countries Keywords: Adolescents, Adverse life events, Resilience, Problem behavior theory, Kenya, Sub-Saharan Africa * Correspondence: carolinekabiru@gmail.com African Population and Health Research Center, 2nd Floor APHRC Campus, Manga Close Off Kirawa Road, P.O Box 10787–00100, Nairobi, Kenya Full list of author information is available at the end of the article © 2014 Kabiru et al.; licensee BioMed Central Ltd This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated Kabiru et al Child and Adolescent Psychiatry and Mental Health 2014, 8:24 http://www.capmh.com/content/8/1/24 Background A large body of evidence shows that adverse events in childhood and adolescence are associated with an increased likelihood of delinquent and risk behavior For example, adverse childhood experiences, such as sexual abuse and household dysfunction, have been shown to be associated with teenage drug and alcohol use, violence perpetration, bullying, as well as early sexual intercourse [1-4] Duke and colleagues [4] also documented a co-occurrence of adverse childhood events based on a large scale sample of adolescents aged 10–19 years in the United States (US) and showed that adolescents who had experienced multiple adverse events were more likely to report violence perpetration towards others Adolescents growing up in slum settings encounter a number of adverse life events, including extreme poverty, poor housing, and persistent exposure to neighborhood crime and violence, which are significantly associated with delinquency [5-9] Multiple pathways through which adverse life events lead to delinquency and behavioral problems have been suggested in the literature Simons and Burt [9], for example, postulate that adverse conditions, including community disadvantage and neighborhood crime, promote social schemas—a hostile, distrustful view of people, the need for immediate gratification, and a cynical view of social norms and codes of conduct—that support delinquent or criminal behavior Gerson and Rappaport [10] also suggest that exposure to violence can lead to reactive aggression Although the bulk of existing studies examining associations between adversity and risk and delinquent behavior have been conducted in high-income settings in the global north, a few studies conducted in sub-Saharan Africa have documented a higher likelihood of problem behaviors among young people reporting adverse life events One study conducted in the urban slums of Nairobi, Kenya, for example, found a strong association between self-reported coerced sexual activity and alcohol use among young people aged 12–24 years [11] Similarly, researchers in a multi-country study conducted in Burkina Faso, Ghana, Malawi and Uganda found that adolescents reporting adverse childhood events, including physical abuse and living in a household that suffered because of a household member’s heavy drinking, were more likely to report substance use [12] In the latter study, researchers further observed a graded association between the number of adverse events reported and the likelihood of self-reported substance use Empirical research on adverse childhood events has tended to focus on the risk factors for, outcomes of and potential pathways through which adverse or traumatic events in childhood may lead to various outcomes However, living in adversity does not inevitably lead to Page of 11 delinquency Many young people growing up in contexts marked by community disadvantage and high levels of violence and dysfunction are resilient and often able to overcome “the negative effects of risk exposure, cop[e] successfully with traumatic experiences and avoid the negative trajectories associated with risks.” (p 399) [13] Indeed, factors that are protective for youth in several settings, such as religiosity [14], may arguably take on more salience among youth at particular risk of engaging in delinquent behavior, in buffering them from their circumstances, and helping them find alternative ways of coping with adversity In this study, we examine the extent to which exposure to adverse life events was associated with delinquent behavior among 3,064 adolescents aged 12–19 years living in two slum settlements in Nairobi, Kenya’s capital city Further, in order to suggest how alternative positive pathways for youth living in extreme poverty may be attained, we examine whether parental monitoring, religiosity, and self-esteem are protective in situations of adversity by assessing whether these variables moderate the association between adverse life events and delinquent behavior Slums or urban informal settlements, which are ubiquitous in most African cities [15], are a unique environment to examine the behavioral ramifications of exposure to adverse life events Slum settlements are characterized by insecurity, extreme deprivation, lack of basic infrastructure, limited socio-economic and educational opportunities, and high levels of violence [15] As noted by Ompad [16], “slum dwellers are often a particularly vulnerable group for a variety of reasons including precarious or nonexistent land tenure, lack of urban resource infrastructure, and tenuous relationships with governments and law enforcement” (p i43) To guide our examination of the behavioral consequences of adverse childhood events as well as potential moderators of the association between these adverse experiences and delinquency, we draw on constructs from Jessor’s Problem Behavior Theory [14,17,18] The framework posits that behavior is influenced by protective factors and risk factors at individual or contextual levels [18] For example, at the contextual level, protective factors, such as parental monitoring, religiosity, or perceived self-worth, promote positive (pro-social or health enhancing) behavior Risk factors, on the other hand, increase the likelihood of risk or problem behavior Protective factors may not only inhibit delinquency, but may also in the event of adverse events, moderate the impact of exposure to risk We also draw on the literature on resilience, which highlights successful adaptations in the presence of risk or adversity and underscores the importance of protective factors [13,19,20] We postulate that adolescents reporting adverse life events would report higher levels of delinquent behavior Kabiru et al Child and Adolescent Psychiatry and Mental Health 2014, 8:24 http://www.capmh.com/content/8/1/24 and that there would be a graded association between the reported number of adverse life events and the level of engagement in delinquent behavior However, we also hypothesize that in line with both the Problem Behavior Theory and the concept of resilience, young people who report adverse life events, but who also report high levels of the protective factors (religiosity, parental monitoring, and self-esteem) would be less likely to engage in delinquent behavior compared with peers reporting low levels of these protective factors Finally, we also examine whether there are gender differences in these associations Methods Page of 11 12–22 years were interviewed This number reflects a 77% response rate among age-eligible young people Overall, refusals were low (